Physicians sign up for electronic records exchange

Dr. Charles Metzger Jr. has spent 12 years in internal medicine. Five years ago, he digitized his Boca Raton practice, converting all his patient files to electronic health records.

Yet, when it came time to get his practice online as part of the Florida Health Information Exchange, which would allow Metzger and other participating physicians to share records of common patients, he needed help.

About a year ago, Metzger was referred to the South Florida Regional Extension Center, an organization that helps member physicians get on the Florida HIE.

“We all will have to do it eventually. They gave me access and helped train me to do it,” said Metzger, who’s also an MDVIP-affiliated practitioner. Going digital “was the right thing to do five years ago.”

It’s even more so today. The state set up the HIE as a network of electronic health records that, according to its website, “allows authorized medical providers to quickly and efficiently review their patients’ medical records to facilitate diagnosis and treatment.”

The exchange enables the secure sharing of health information between authorized medical providers, whether through a Patient Look-Up (PLU) service or the Direct Secure Messaging secure email program, said Lisa Rawlins, executive director of the South Florida Regional Extension Center, a division of the Health Choice Network, a not-for-profit organization launched under the high-tech health care provisions of the American Recovery and Reinvestment Act. The center – one of 61 such centers nationwide – serves the eight-county region from Key West to Vero Beach.

In August 2009, the Office of the National Coordinator for Health Information Technology announced the State Health Information Exchange Cooperative Agreement Program. Using $20.7 million in federal funding over four years, the Florida Agency for Health Care Administration supports a statewide HIE. AHCA awarded Harris Corp. a four-year, $19 million contract to implement the statewide HIE infrastructure, according to the HIE website.

The advantage of the HIE is simple. As the exchange develops, participating doctors will be able to access the records of their patients who are also seen by other physicians on the exchange. For example, if a cardiologist on the exchange adjusts a patient’s medication, Metzger can access that patient’s records. Any such patient first must give signed approval to have his or her records on the exchange.

Funded by federal dollars

Today, the center has 2,800 “priority primary care” member physicians whose practices generally have 10 or fewer doctors. These include pediatricians, family doctors, internal medicine practitioners and OB-GYNs. Membership is free and is funded by federal dollars, Rawlins said. Specialists, like cardiologists, pay $600 to join the center. To date, some 800 have gone live with the electronic health records platform.

Smaller primary care doctors are providing upward of 80 percent of all data on the exchange, Rawlins said. Adoption of electronic health records has grown from about 10 percent five years ago to between 30 and 40 percent now. To push adoption along, the organization has an aggressive recruitment campaign to draw physicians in and help them understand adoption, Rawlins said. The center conducts needs assessments based on what she calls “meaningful use.” Its Open Lab allows physicians to explore multiple platforms to help drive their decision, she said. The cost of electronic health records programs can range from free (for more limited solutions) to $15,000 a month.

The transition from paper to digital creates a safer, more efficient practice and patient experience, said Dr. Bernd Wollschlaeger, a North Miami Beach family physician and executive committee member and board member of Florida HIE.

“It’s a more accountable healthcare system for practitioner and patient,” he said. “It’s a more patient-centered, partner-based system.”

With electronic health records, the system and providers can be held accountable for performance, added Andrew L. Carricarte, president and CEO of IOS Health Systems. The Miami-based health care technology company’s system will help facilitate physician access to the network. As he put it: You can’t manage what you can’t measure.

“This is a necessary component to health care reform in the country,” Carricarte said. “The purpose behind EHRs is the ability to track and measure what we’re producing in health care. We don’t measure or reward according to performance and so we don’t have the right model to incentivize according to care and performance. This is a piece of a long process.”

Today, the move to electronic health records is an option. By 2014, between the health care law and requirements of government and private payers, it will be a mandate. Some fear it. Others welcome it.

“The writing’s on the wall,” Rawlins said. “We were on the verge of massive change in the health care industry. We seek to be the trusted adviser to the small independent practitioners to stay independent and help them achieve their bottom line.”